Unveiling endothelial resilience: Comparative analysis of phacoemulsification and manual small-incision cataract surgery with 6-month postoperative surveillance

Abstract

Abstract Purpose: The purpose is to find out changes in endothelial cell density (ECD) in eyes undergoing phacoemulsification (Phaco) versus manual small-incision cataract surgery (MSICS) or small-incision cataract surgery (SICS) with 6-month postoperative follow-up. Methods: An observational prospective study of 200 eyes of 200 patients was conducted over 13 months (December 2016–December 2017). Patients with senile cataracts undergoing surgery by any of the two methods (SICS and Phaco) were included in this study. After preoperative examinations, patients underwent surgery by either Phaco or SICS according to patients’ preferences and affordability. All intra- and postoperative data were collected prospectively, and the minimum follow-up was 6 months. Data were entered into an Excel file format and subsequently analyzed with SPSS (Statistical Package for the Social Sciences), unpaired t-test, paired test, ANOVA test, and Pearson correlation coefficient. P <0.05 was considered statistically significant. Results: The mean ECD during the preoperative period in the SICS group was 2537.789 cells/mm2 (range = 2004.3–3564.7) and in the Phaco group 2592.878 cells/mm2 (range = 2020.0–3434.3). There was significantly more cell loss in SICS at 1 week than in Phaco (P = 0.0001). On 1-month and 3-month follow-up, gain and stabilization in ECD were noted in both the groups which was significantly more in the SICS group than in the Phaco group (P = 0.001 and P = 0.004, respectively). However, at 6 months, ECD loss was stabilized for both the groups, and there was statistically no significant difference between both groups (P = 0.108). Conclusion: While there is an initial difference in EC loss between MSICS and Phaco, there is a significant stabilization observed over the 6-month postoperative period, resulting in comparable EC loss between the two methods.